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346 2nd St (vault) SPARED 7/02/03, 7 :25:02 INSPECTION TICKET PAGE 8 M OF ATLANTIC BEACH INSPECTOR: LARRY J HIGGINS DATE 7/02/03 ---------------------------------------------------------------------- ADDRESS . : 346 2ND ST SUBDIV: TENANT, NBR: WOOD ARBOR,TRELLIS,PLANTE CONTRACTOR HEYWOOD A. DOWLING PHONE (904) 246 -1833 OWNER FORD, VIRGINIA PHONE PARCEL : 169168 -0000- - APPL NUMBER: 03-00026321 RESIDENTIAL ADD/RENOVATE/ALTER ---------------------------------------------------------------------------- PBRNIT: BLDG 00 BUILDING PBRNIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ----------------------------- 13 01 7/02/03 -------------------------------- - - - - -- COMMENTS AND NOTES -------------------------------- - - - - -- CITY OF ATLANTIC BEACH 1 i 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247 -5826 Application Number . . . . . 03- 00026536 Date 7/22/03 Property Address . . . . . . 346 2ND ST Tenant nbr, name . . . . . . RE -ROOF Application description . . . ROOF Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 4470 Owner Contractor ------------------ - - - - -- ------------------ - - - - -- FORD, VIRGINIA BENTON BUILDERS & ROOFING INC 346 2ND STREET 2865 PLUMMERS COVE ROAD ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32223 (904) 262 -7663 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 83.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 4470 Fee summary Charged Paid Credited Due ----------- - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- Permit Fee Total 83.00 83.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 83.00 83.00 .00 .00 BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. BUILDING OFFICIAL Cc: �=y,,V Jlf, C ITY OF ATLANTIC BEACH D. Ford J BUILDING / ZONING DEPARTMENT L. Higgins s J 800 Seminole Road S. Doerr J� Atlantic Beach, Florida 32233 (904) 247 -5800 (904) 247 -5845 Fax PLAN REVIEW COMMENTS JUL 2 1 2003 Permit Application # 03 - ZL 3L Property Address: Applicant: Project: !✓ — ; i= This pe it application has been: Approved Reviewed and the following items need attention: Please re- submit your application when these items have been completed. Reviewed By: Date: .CITY OF ATLANTIC BEACH PERMIT - CALCULATION SHEET Address c 4 L 5 , 7 — Date Heated Square Factage p er s ft ..= q $ Garage /Shed @ p er.sq ft =.$ Carport/Porch • i$ o er sq ft.= $ Deck @ $ D er sq ft = $ .Patio �@ $ p er sq ft = $ TOTAL VALUATION:$ .Total Valuation 1st $ /DOt� $ �t $ a a Remaining Value ss per thousand .` or :portion thereof TOTAL BUILDING FEE $ < j ' + 1/2 Filing Fee (. ) F.i rep Iaces . @. $15,00. $ .-BUILDING PERMIT FEE WATER IMPACT FEE $ SEWER IMPACT.FEE $ '.WATER METER /TAP $ CAPITAL.IMPROVEMENT, $ SEWER TAP $ )-RADON (HRS) .0050 $ SECTION H PAVING ( ) $ HYDRAULIC SHARES $ CROSS CONNECTION $ ( ) SURCHARGE .0050 $ OTHER $ GRAND .TOTAL DUE ADDITIONAL PERMITS OR FEES Mechanical .. Plumbing Electric /New Electric /Temp ;Swimmingpool Septic Tank Well Sign Finish Floor Elevation Surve; .Other CALCULATIONS and /or NOTES: JUL 2 1 2003 CITY OF ATLANTIC BEACH ROOFING PERMIT APPLICATION Date: Job Address: ;3 ,�„ 5 Atl4.rfjc— R r''I 3 2 33 Owner of Property: Address: 3rf 2 N y, sY. �4t( ,Q�G, �'j 3 22 3 3 Telephone: x 46 — z C 4 v Contractor: Q Faa 18-X4( "t% 11JQcp pdlvd. 7k State License Number: cr-c o 3 G� 3 f Contractor's Address: s, .-e e Telephone: z 6.2 — 76 G. 3 Fax: Scope of Work: _ /-2,. -Q Deck Slope: _ S 1 iz-- Greater than 2:12 Less than 2:12 Valuation of work: Product Name (Example: Timbe ine): ' Manufacturer (Example: GAF . Cz, ASTM Designation(s): s t t 1CQ Required Inspections: Sheathing an Signature of Owner: - Date: 7/ 0 10 Signature of Contractor: Date: 1/21/0.3 AS TO OWNER: Sworn to and subscribed before me this ( day of v i , 20 0- - 3 State of Florida, County of Duval Notary's Signature: ?nC MY COMMISSION # CC914121 EXPIRES Personally o June 1, 2004 Produced entification ,pF i� • BONDED THRU TROY FAIN INSURANCE INC ❑ i` Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this 2 ( day of 20 State of Florida, County of Duval Notary's Signature: [R Personally kn n '� rryp lames H. Miller MY COMMISSION # CC914121 EXPIRES ❑ Produced i catiopa, Tune t, 2004 Type of identification d BONDEDTHRU TROY FAIN INSURANCE, INC. 800 Seminole Road • Atlantic Beach, Florida 32233 -5445 Page 1 Telephone: (904) 247 -5800 Fax: (904) 247 -5845 • http : / /www.ei.atiantic- beach.fl.us NtSySkYnlWlem ypJU GmlMmMUtDM /�,��/ I 1 Mrlulne H• Itt l>��M ��N� , conwma ►rotulbn • Promises � , poYry) r�ntnertO�K i I 13/• - x 39Y." Metric Timberline Ultrf shinngples 12" x 36' English are available nationwide � 8bte Warranty ASTM D3018 Type 1 / ASTM 03161 Type 1 4 Bundles /Squa( e Warranty ASTM D3462' Approx. . 320 Nails/Sq: 256 Nails/Sq. Metric) p f 5l'ingle Dade County Approved Approx English) tl f in UL Meets Wisconsin Administrative Code 5 e" Exposure (Metrij 7 Wind Test Approx. 64 Pieces/Sq. Metric) 5" Exposure (English) For MsiiwFie R e Cap 5hi�?gks, use matching TIMBEAT Xe '2 l 7 and CSA Al23.5 -98 ApproX. 80 PieceslSq. (�nglish) orPx dl!)GE'f6dDECapStVnples Timnie'1'ulw 13% "x 39%' Metric ' Original TYmberline•shioglea a x .1 E 12" x 36" English are available nationvrlde i 30 -Year Ltd. Transferable Warranty ASTM D3462 (Availabla from Approx. 256 Nails/Square (Metric) 70 mRJ1 Ltd. Wind Warranty select plants as required by loca code)' Approx. 320 Nails /square (English) Fiberglass Asphalt Shingle Dade County Approved (Tampa only) 5' /t•' Exposure (Metric) Class A rating from UL Meets Wisconsin Administrative Code 5" Exposure (English) Passes UL'997 Wind Test Approx. 64 Pieces/Square Metric For DbllnrtMRd4c Cap,shts,use MetctanpTIMBERV GSA Al 2&5-M90 and CSA Al23.5 -99" Approx. 80 Pieces /Square English) orPauFKRID E'Rldg Cap, Ales ASTM; D3018 Tyype 1 4 Bundles /Square ••fhodecllhWcatoeuaarw�soodY • ASTNF'Dall61• Type 1 13rx 39'/.' Metric Timberiine'25 shingles VK 111 f.s lA� � 12" x 36 %' English are available nationwide 25 -Year Ltd. Transferable Warranty ASTM D3462 (Available from Appprox. 312 Narls/Sq. (English) 60 mph Ltd. Wind Warranty select plants as required by local code)' S ` /t" Exposure (Metric) Fiberglass Asphalt Shingle Meets Wisconsin Administrative Code 5" Exposure (English) Class Aratin99.fromUL Approx. 66Pieces/Sq. Metric)) For 0�ib �1tvp R sir n�las. use maahiN*BERTEXI Passes UL' 997 Wind Test Appprox, 78 Pieces/Sq. �Englisb) or Pau1<RIDGE' Aldge Cap siungies CSA At 23.5- M90and CSA All 23.5 -98° 3Bundles /Square FluduclsMVerdroGNeemteaaae ASTM Type 1/ASTM D3161 Type 1 Approx. 264 Nails/Sq. (Metric) 12 "x 36" Shaded sections indlcate available ty Max (1 10 l i 30 Year Ltd. Transferable Warranty GSA Al 23.5-M90 and CSA Al 23,5-98 Approx. 80 Pieces /Square �. 80 mph Ltd' Wind Warranty ASTM D3018 Type 1 3 Bundles /Square Flberplas$ Asphalt Shingle ASTM D3161 Type 1 Approx. 320 Nails /Square Cla4A rating from UL ASTM D3462` 5' Exposure Passes UL 997 Wind Test Meets Wisconsin Administrative Code note} 13'/: x39'h "(� eU1c Royal Sovereign•shinglesare - 12" x 36' (English available nationwide 911111!0L9 1' 25-Year Ltd. TraWerable Warranty ASTM D3018 T e 1 Approx 65 Pieces (Metric) . 60 mph U6 Vend Warranty ASTM D3161 1 Asphalt Shin le ASTM D3462 Approx. 3 gu NabS uam R �� p 9 Approx. 320 Nails /Square En Glass A rating from UL Dade County Approved Ap rox 260 Nails/Square Metric Paw UL 997 WK1d Test Meets Wisconsin Administrative Code 5' re (En lish) CSA Al23.5 =M90 and CSA Al23.5 - 98 Approx. 80 Pieces.Square (English) SIN' Exposure ( tric) S 1 X3 ( e Metric) Sentinel'shing /es are - ... - - - - -- 12' x 36' (nglish •,, s N t r•a L Is available nationwide 20- Yoar;Ltd. Transferable Warranty ASTM 03018 T ype 1 3 Bundles /S uare 60 mph Ltd, Wind Warranty ASTM D3161 T pe 1 Approx, 320 Nails /Square Engglish) Fiberglass Ast,halt Constwctlon ASTM 03462 (Avallable from select plants)" Approx. 260 Nails /S uare �Metrlc) Classi Ratirigg from UL Approx. 80 Pieces /Square (English) 5 Exposure (English Passes UIL 917 Wind Test Approx. 65 Pieces/Square (Metric) 5' /1' Exposure (Metric) 'lhlt Orr r*Vfac3urI4 to meet or exceed ASTM D3462; values from subsequent testing may vary depending on storage conditions 15 5 MIN. RETURN Book 11141 Page e34 PHONE # NOTICE OF COMMENCEMENT State of Tax Folio No. County of To Whom 1t May Conc rn: The undersigned hereby informs you that improvements will ba made to certain real property,, and in accordance with Section 71'3 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT. Legal description of property being improved:� Address of property being improved: General tim-ription of improvemrntd: z . Owner. Addreu -� r'3 �' A Owner's interest in site er the improvement: /A. Fee Simple Titleholder (if other than owner): - - nQ Address: Contr actor. —; t ,��i AIiW QS9: ' .. f, 1 f `'� ", A IL Phone No: c y, ;; 7, i f4, -� Fax Surety (if any): Address: Amount of Bond $ Phone No: 'Fax No: Name and address of any person making a town for the constrtk don of the improveanents. Name. Address: _ Phone No: - — Fax No: Name of person within the Slate of Florida, other than himself~ dcaigna cd by owner upon whom notices or other documents ma 1je s" d: Name: Address; Phone No: Fax No: In addition to himself, owner desipatm the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2xb.),'Florida Statues. (Pill in at Owner's option). Name: _..— Address: Phone No: Fax No: Expiration date ofNodco of Commencement (the expiration date is one (1) year from the date of recording unless a diffWCAt date is speciticd): THIS SPACE FOR RECORDER USE ONLY WNE Signed: Date : Before me is day of in the County r L p 2720 of val, Stataef Florida, has persoulty.sopmed � I r I 1 L, 1 '�• Pa ea 234 Not ub is at ge, State of.,lorida, Co City ofOuval. Fred i Rtcatdad _ Y 07/08/8003 0164 -.47 PM My commission expires : Jul FWD Personally Known: Tr Y ur CLEK I1 COURT f 5000 JE R { 1.00 �; � MV COMMISSI 0N # 6 00 121301 EXPIRES: Mhy 27,200b u u c r o r n n n ? y � 1 J r ✓r,� . CITY OF ATLANTIC BEACH i 800 SEMINOLE ROAD } r ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247 -5826 Application Number . . . . . 03- 00026321 Date 7/01/03 Property Address . . . . . . 346 2ND ST Tenant nbr, name . . . . . . WOOD ARBOR,TRELLIS,PLANTE Application description . . . RESIDENTIAL ADD /RENOVATE /ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 25000 Owner Contractor ------------------ - - - - -- ------------------ - - - - -- FORD, VIRGINIA HEYWOOD A. DOWLING 346 2ND STREET 241 ATLANTIC BLVD. ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 246 -1833 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 155.00 Plan Check Fee 77.50 Issue Date . . . . Valuation . . . . 25000 Fee summary Charged Paid Credited Due ----------- - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- Permit Fee Total 155.00 155.00 .00 .00 Plan Check Total 77.50 77.50 .00 .00 Grand Total 232.50 232.50 .00 .00 x BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. BUILDING OFFICIAL j !rL�J` CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD J� ATLANTIC BEACH, FLORIDA 32233 -5445 fis TELEPHONE: (904) 247 -5800 FAX: (904) 247 -5805 SUNCOM: 852 -5800 http: / /ci.atiantic- beach.fl.us PLAN REVIEW COMMENTS Permit Application Applicant: ° f Address: 3 P -,2 lid -S4 Project: o - c l ao s, z�Jn nl r ,our application is approved o Your permit application has been reviewed and the following items need attention: Please re- submit your application when these items have been completed. Reviewed by Signed Date Contractor Notified Date Jun 16 03 12:23p Information Systems 247 -5845 p.2 W ^N. 1 1� r ? - � T CITY OF ATLANTIC BEACH BUILI)ING PERMIT APPLICATION I (ALTERATIONS /ADDITIONS) Date: Job Address: P Owner of Property: Address: Telephone: Legal Description: ock Number: ! Lot Number: Zoning District: Contractor: i' State License Number: Contractor's Address: Telephone: ° ��J. J Fax: Describe proposed use and work to be done: r Present use of la . d or uilding(s): - Valuation of proposed construction: What are the dimensions of the added space: feet x feet Will the added area be heated and cooled? _ New electrical or increase in service? New plumbing fixtures? /Jh New fireplace ? New heating /air conditioning? Is approval of Homeowner's Association or other private entity required? & If yes, please submit with this application. Will th' roject involve changes in elevation, site grade or any use of fill material or the removal of any trees? NO Applicant certifies that no change in site grade or fill material will be used on this project. ❑ YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. 5RIN 0. Applicant certifies that no trees will be removed for this project. ❑ YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board, which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate Incomplete applications may result in delay in issuance of permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904 - 247 -5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre - construction or post - construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane, Atlantic Beach, FL 32233 Telephone: (904) 247 -5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner /Contractor Affidavit if owner is contractor, and four (4) complete sets of construction plans to the Building Department, which is located at the Atlantic Beach City Hall, 800 Seminole Road, Atlantic Beach, FL 32233 Telephone: (904) 247 -5826 800 Seminole Road - Atlantic Beach, Florida 32233 -5445 Telephone: (904) 247 -5800 - Fax: (904) 247 -5845 - http : / /www.ei.atlantic- beach.fl.us Page I Revised 1/14/03 Jun 16 03 12:23p Information Systems 247 -5845 p.3 In addition to construction and engineering detail, plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. I. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures, temporary and permanent, including setbacks, building height, number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works, a pre - construction topographical survey. 4. Any significant environmental features, including any jurisdictional wetlands, CCCL, natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all information provided with this application is correct. Signature of owner: 1 Date: I hereby certify that l have read and examined this application and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work ill complied with, whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel th rov' ons of fed , state or local es, regulations, ordinances, or laws in any manner, including the governing of construction or the o ce o nstfucti of the I understand that the issuance ofthis permit is contingent upon the above information beingtr d rr an at the s ppo ng data have been or shall be provided as requir Signature of Contract , Date: �✓ Address and contact ' formati of person to receive correspondence regarding this application (please print). Name: Mailing Address: —5 Telephone: �' Fax: E -Mail: AS TO OWNER: Sworn to and subscribed before me this ) 1 day of m� , 20 State of Florida, County of Duval JENNIFER SCHLUE'i ER ``. C.� l` /l MY COMMISSION # DG 17.1301 Notary's Signature: " \ EXPIRES: May 27, 2006 Public Underwn;ers ❑ e Pf,F gondedThuNota.ry Personally known ❑ Produced identification Type of identification produced AS TO CONTRACTOR: ' Sworn to and subscribed before me this 4l f�1 day of 2. State of Florida, County of Duval q `r Notary's Signature: 1:�Y Py''• JENNIFER SCHWETER =iR MY COMMISSION # DD 121301 Nr Personally known EXPIRES: May 27, 2006 rsonaedThru Notary Public Undenvriters Produced identification Type of identification produced 800 Seminole Road - Atlantic Beach, Florida 32233 -5445 Telephone: (904) 247 -5800 - Fax: (904) 247 -5845 • http : / /www.ci.atiantic- beach.f.us Page 2 Revised 1/14/03 K &E 10 8188 8 -71 MC2828• - ti1A� TD 0 T ATLA"T /C BE�1Ch� _ •, / N /A v �5 S 7 E' T E., SpL / T z ! Gi a _ g o 00 c U N N N O V W rn m rn LLI z a �O a o o .� ■� L oe i cc S c l ^) Z z m '�/ 0 ie S CL � "DU.(/,C7. 9T /q�/ SU.PYEy.' � yIAY ¢, /97e ` ?/c�rL� : _ Fc'?U•Ul> ,4L� /.�D�.S'.__ I HEREBY CERTIFY THAT THE ABOVE-- Z O 7 S LEGEND: WAS SURVEYED BY ME. AND THAT Ti �i V CONCRETE MONUMENT IS LOCATED UPON SAME AS SHOWN AND THAT THERE ARE NO ENCROACHMENTS UPON IRON CORNER SAID La_? _ _ CLARSON AND ASSOCIATES, INC. !� WOODEN STAKE / ✓/A l2 GIN �9 / / C) CORNER SIGNED _,__ _,l 1 9 G.__ / f ' / ir �� - _..__._ !._ ✓- _..._._ X CROSSCUT SCALE: - -- R ISTEREO SURVEYOR NO2?k4o FLA. X —X— FENCE F.B. NO.._.._ ',- PG.-- 4 - -- - -a gigs 5 -74 MC Zola TD .BL OC.'e .3 �9S _SHO�i�J O/V /11.9. OF .5414501 V/.5/dn/ "A '' ATLAA./T /C 9,eE� C V .45 ` .C•�ECD,t�ljElJ /�/ .UG �/ T. B D D,� �i ; .oA GE l0 9 O.� . i�UB L iC k'EGO>PO S OE OU iiA L C O U�/ TY, FG O eil�A, X O ,t'O / RO/V 26.7' Fp,R4� y of Atlantic Beach Planni and Zoning Department l TI Is approval verifies compliance with applicable zc ning, subdivision and other focal land C � dc velopment regulations, but does not constitute al proval for the issuance of permits. Compliance Q r w h Florida Building Code and all other applicable �8: 7 to al, State and Federal permitting requirements mist be verif4bs ' e of the City of Atlantic Beach Buildir to issuance of a B ilding Per T A proved By R Development Director I , h z< v t v M 'a -4 U N M M ? W Q /3 ✓ran -,ti �� ? 3 LL (71 Ir W Q U d W U N N N V N (D C Q w (D m rn C S ..,., W Q a ■ ■ ■ z w Y3 Z a ?4.: x_52 �Z E 60, io0, 'IB O O ■ �■ O eu 13 a A Z) j 0 Z z o oa W .PON 1/Q f0. /POV LlL/L Y /9 / I 74 FO.P : rP0.3E.P T,$' �'�/TE"•2 o.P /SAS /it/� �"Or/,r✓',C7. sU.PvEy.� it �l,4 y �. /97'' '?/n r�. FOU -l/O .4« i.P4�'.�''. HEREBY:CERTI FY THAT THE ABOVE `_ 0 7— _•__ LEGEND:. W AS ME AND THAT` . +' ��c./ CONCRETE MONUMENT IS LOCATED UPON SAME AS SHOWN AND THAT THERE ARE NO ENCROACHMENTS UPON IRON CORNER SAID_LE??' __ CLARSON AND ASSOCIATES, INC. _ !� WOODEN STAKE SIGNED /t!IA.eaxv _/ 19 7G.- ',�/ / � X CORNER SCALE: / �r 1!- __ ✓'li1_ ... -.. - -- CROSSCUT - - -- A ISTERt =.O SURVEYOR NO, ij46)FLA. X -X- FENCE F.B. NO..AO Z5 / 30 /'Lbb.J lb: 'Lb yb4 i f F7�4 �u I G Hr« r, LGJ1L71YJ r,u� w PI y {I r ti II //11 I { (I I II II,r y I �J � i j I /' Ifi� II {I �I �' II Il � i iJ' II;% i I•{ I u I b 8 WidityH ;' j I I ly !I a' II I II' LI+ II I i 1 II II II II II ,G, 'I II 11 11 IJ, II I Z ,�r�,�, I II II II it II I II II II II II I I II II II' If II I� `II II II !1- II I I I 7'A'kh'�' GL, 5LK. 1 11 . I II II I' U II II , II II II I G L. 15M l,^T10 WCAPf*- If i �i R^1��A 1 I I II II II II II II II If II 11 ! I II II II fI II U V � II II II it ll II I I II n I II It � I� II II II II II jl I I If II II I. II II II II I �J _ If If II II I II II II II I� ,�I/ II II II II 4' o� 1 !I a n F(V u n II If 1 ! I 4'aUALK I II i� II II II I II II.. If 9 j I II II II I I; II II II II II I � V I n JI a I� II n II u n II I I � II II II I �I II Ir 11 II I II II -_ JI I Z Z�x �� t` ♦�5 /3i: %/U6J lb:'Zb �g4- 'L'G�-lb74 �UIt HKIYt Lt alulVa rr+uc ul rl o l 6 FRC�1�T ,� ........ -- .. � y _ CITY OF ATLANTIC BEACH y1 f` 800 SEMINOLE ROAD Vie•. ATLANTIC BEACH, FLORIDA 32233 -5445 TELEPHONE: (904) 247 -5800 ` , P FAX: (904) 247 -5805 SUNCOM: 852 -5800 S � http: / /ci.atlantic- beach.fl.us, ENTS PLAN REVIEW COMM Permit Application Applicant: l4 )ti Address: =3 q L -2 ` " -S4 Project: • r q/ application is approved o Your permit application has been reviewed and the following items need attention: Please re- submit your application when these items have been completed. Reviewed by Signed Contractor Notified Date Jun 16 03 12:23p Information Systems 247 -5845 p.2 rfrl id CITY QF ATLANTIC BEACH B'VIL)ING PERMIT APPLICATION (ALTERATIONS/ADDITIONS) r Date: U/ Job Address: Owner of Property: Address: y/ Telephone: —r Legal Description: ock Number: Lot Number: Zoning District: Contractor: " d i" State License Number: Contractor's Address: Telephone: Fax: r Describe proposed use and work to be done:' r Present use of lad or building(s): Valuation of proposed construction: What are the dimensions of the added space: feet x feet Will the added area be heated and cooled? New electrical or increase in service? New plumbing fixtures? New fireplace? O �V New heating /air conditioning? Is approval of Homeowner's Association or other private entity required? _ If yes, please submit with this application, Will t rolect involve changes in elevation, site grade or any use of fill material or the removal of any trees? NO. Applicant certifies that no change in site grade or fill material will be used on this project. ❑ YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building ,�/ Permit. Lisf'N . Applicant certifies that no trees will be removed for this project. ❑ YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board, which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate Incomplete applications may result in delay in issuance of permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904 - 247 -5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre - construction or post - construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane, Atlantic Beach, FL 32233 Telephone: (904) 247 -5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner /Contractor Affidavit if owner is contractor, and four (4) complete sets of construction plans to the Building Department, which is located at the Atlantic Beach City Hall, 800 Seminole Road Atlantic Beach, FL 32233 Telephone: (904) 247 -5826 800 Seminole Road - Atlantic Beach, Florida 32233 -5445 Telephone: (904) 247 -5800 • Fax: (904) 247 -5845 - http : / /www.ci.atiantic- beach.fl.us Page 1 Revised 1/14/03 Jun 16 03 12:23p Information Systems 247 -5845 p.3 In addition to construction and engineering detail, plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures, temporary and permanent, including setbacks, building height, number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works, a pre - construction topographical survey. 4. Any significant environmental features, including any jurisdictional wetlands, CCCL, natural water bodies. 5. Impetuous Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all information provided with this application is correct. Signature of owner: Date: I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work ill complied with, whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel th rov' ons of feed , state or local es, regulations, ordinances, or laws in any manner, including the governing of construction or the o ce o nstfucti of the I understand that the issuance of this permit is contingent upon the above information being tr d rr an at the s ppo ng data have been or shall be provided as requir Signature of Contract o .., Date: Address and contact formati of person to receive correspondence regarding this application (please print). Name: Mailing Address: Telephone: �;- Fax: E -Mail: AS TO OWNER:` Sworn to and subscribed before me this day of 1 20 0 State of Florida, C ounty of D uval y •, JENNIFER SCHLUE E'ES /L :• MY COMMISSION # DG 121301 Notary's Signature: �'• 'e: EXPIRES: May 27, 2006 %?� •...• Thru Notary PublkUndewnters ❑ personally known of �; Bonded ❑ Produced identification Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this t � day of ` �`�° , 2t. State of Florida, County of Duval Notary's Signature: 4KY .Py' •,, JENNIFER SCHLUETER MY COMMISSION # DD 121301 EXPIRES: May Personally known ,p, y 27, 2006 Bonded Thru Notary Public Undenrriters Produced identification Type of identification produced 800 Seminole Road • Atlantic Beach, Florida 32233 -5445 Telephone: (904) 247 -5800 . Fax: (904) 247 -5845 • http : / /www.ei.atiantic- beach.fl.us Page 2 Revised 1/.14/03 S MIN. RETURN PHONE # Book 11191 Page Page 234 NOTICE OF COMMENCEMENT State of ' / , - , �� -, . Tax Folio No. County of // To whom It May Con4n: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT. Legal description of property being impro ved: Address of property being improved; .� C -c►� r �' iT — i General description of improvements: % Owner, Address: y Owner's interest in site of the improvement: Fee Simple Titleholder (if other than owner): Name: _..— Address: - ._...._.._ _.,.. -�-- ('� Contractor: !, �„( Address. 1 `(� Phone No: ° Fax N Surety(ifany): .._ ..........� �J._ Address: - Amount of Bond S Phone No: _ _ _ Fax No: Name and address of any person making a loan for the construction of the improvements. Name: . Address: Phone No: �— Fax No: Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents ma se Name: Address; Phone No: Fax No: In addition to himsel C owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2xb), Florida Statues. (Fill in at Owner's option). Name: Address: - Phone No: Fax No: Expiration date of Notice ofCommencement (the expiration date is one (1) year from the date of recording unless a different duce is specified): TIES SPACE FOR .RECORDER'S USE ONLY WNE Signed: Date:��y Before me tls 1 7_ day of �� in the County B Oe K 20012720 of val, State -bf Florida, has personally p arF oak 31 I l � L , 1 --' Palet 234 Nola Public st ge, State of lorida, C my of Duval, Filed I RacaTded oy 07 /02/W 01607 PM My commission expires: e� ' M JIM FULLER T Personally Known. �� or FI CdUR s 1.00 rA MY CO M oD 121301 Z d T LgtiB ON ' ,F EX Wd�! Z C00Z Z Iri� , W in g 'M ONSTRUCTION 09114« eki fto COMPANY facsimile transmittal To: Jennifer /Building Dept Fax: 247 -5845 From: Pete Dowling Dees; July 2, 2003 - Re: Recorded NOC for the Ford Job Pages: 2, incl cover CC: D U rgent For Ravlew C] Please comment r1 Plena Reply a Phase Recy 7 Jennifer: NOC for Mrs. Ford's job as discussed..... 241 Atlantic Blvd., #5 Neptune Beach, FL 32266 904 246 -1833 • Fax 904 247-3147 l d L5V8'�N Wdbl:l Coon 'z inr E E DEPARTMENT OF BUILdING 3071 CITY OF ATLANTIC BEACH, FLORIDA PERMIT NO. i PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB Dat 4 19 Valuation $ 5 3. o f) a . an Fee $ L This permit not valid until above fee has been paid to City Treasurer, and is t aabject to revocation for violation of applicable provisions of law. t This isto certify tha Roberts Enterprises, Inc. has permission to buil �i Y td �! 3 t�f X ( X }' X X K! , i1u p l e X Classificatio r e 2 i d e n c e 7n Ownedby W1WXYNiXXKMj(d Virrjina Ford Lot 17 Bloc 3 S AD A/ b House No. 3 41�. ? n ri !� f_ r f-' P f According to approved plans which are part of this permit NOTICE —ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIR MONTHS n AFTER DATE OF ISSUE —� 4 ► O Building material, rubbish and debris from this work moat not be e d in public space, and must be cleared pl aced up and hauled away by either contractor or owner. Building official. FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER PLUMBING ELECTRICAL SEWER WATER t FOR OFFICE J USE ONLY Date- - - - - -- / � .....19 ...... Permit #- •----- • - - - - -- - - - -- ----Fee $ �•/ CITY OF ATLANTIC BEACH Valuation $.._- 3 ........ ... ............. FLORIDA House 2 -- �----- ...!; •- ....•. D 90 - � - - - - - -= I APPLICATION FOR BUILDING PERMIT L ---- :.,-'` ---- ------------------------------ =7. °.� Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure described. This application is made in compliance and conformity with the Building Ordinance of the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether herein specified or not. The Contractor or Owner - Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub- contractors engaged by him are duly licensed in the City of Atlantic Beach, Florida. To prevent delay or embarrasment regard- ing intermediate or final inspections it is suggested that a list of sub - contractors be submitted to this office so that licenses can be verified. /' Date .................... 14 --- - - -1.s .................................. 19 -- 4 '- - -- J . -.- Address__ / __� 4g - - --- -� - -.- ( PA P Owner.---- �1. 1. �. G1�?-. A ------ �Q�A-•------•---------------- •- •--- •- •---- - - -... �Z_y..4? �•., ! 1.�---- ._Tele hone No.Z.q9_ 4- - -.0 Architect -- ------ - - -- -- -------------------.....---•-•--...... .--- --....•- •..._......... - -•• - - - -- Address - - -- ................................................. --- - - - - -- Telephone No ---------------- - ---- - - - - - -- Contractor Builder._ _ --- S y . Address__ 1OIG4n•- ;.�._.!1�'_- ..Telephone Lot No------- - - - - -- [7 .......................... Block No.----- �----- - - - - -- - - - - -- -Sub Divisi A .YLifNTi - ,^�� l i ......................... Zone ----- - - - - - -- --- --- • - - - - -- -- -- Street----- �_U"U. - -- Side Between----- ....Jl '!-- --_---------- - - - - -- -and------- �_z�_- l -- a- %!r --------------- Sts. - -- ---- -- - --- - -- (''� Valuation $_. -._ - ,- _QG�? -- -For what purpose will building be used -- .__l.,L�. p(? !!!4 ........... Type of construction ---- WAP.0 - - - --6 —4m Dimensions of Building ----- .--34 x-44--- . - - - - -- Dimensions of Lot _- _---------- .- - - 1.. V ...............:Size of Footings ....... C.t_Xt!� .............. il 1u6 Q Size of Piers. ------- ._.- --- ------- -- --__.- _..Size of Sills ......... _ - ....... -_ .......... Greatest Sill Span in ft.-. ------ ................ Type Roof --- ...`��_ ... ...... .. . How will Building be Heated?. -_ -. ........................................ Will Building be on Solid or Filled Ground ?. .... V: dP . ................. Size of Ceiling Joists-_ ... .... 2.- 1C_AS ------- -- _ ------ ., Distance on Centers ........ .. .................. Greatest Span ----------- 12..__._.Q._............ It Size of Floor Joists _---------- -- --- ------- - - - - -- Distance on Centers .......... .... A_" ................. , Greatest Span ............. /.z.. 0--- - - - - -. - - -- " Size of Rafters.- ____.- . -------- X -- --- - - - - -- - - - -- ------ Distance on Centers.. ..... ..... _ . ..................... Greatest Span .............. it This rectangle is to represent the lot. Locate the building or buildings in the right position. Give distance in feet from all lot -lines and existing buildings. REAR LOT LINE $4 Two copies of plans and specifications shall be submitted with application. Inspections required. 1. When steel is in place and ready to pour footing. W W 2. When steel is in place and ready to pour columns and /or lintel. Z I Z 3. When steel is in place and ready to pour beam. a a 4. When framing is completed. S S 5. When rough plumbing is completed, and ready to cover up. W W 6. When septic tank drain field or sewer is laid but before it is covered. q A 7. Electrical inspection by City of Jacksonville. M 8. Final inspection. Note: In case of any rejection, re- inspection MUST be called for after 7• 3 ` ` 7' �'" corrections are made. W FRONT OF LOT $( In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said work in accordance with the attached plans and specificatio , which are a part hereof, and in accordance with the building regulations of the Cit is Bea I Address -- Signature of ....t1 ....... Y. Signature of Owner. Pf-...- • - - - -- ---------- - -• - -- Address _.6�.6.._...C2.T'�' > AcK C y- ........... CITY OF ATLANTIC BEACH APPLICATION FOR SEWER CONNECTIONS PERMIT NO. ' - DAT E�� LOCATIO / (, STREET LOT NO BLOCK NO. {� OWNER TYPE OF BUILDING ��. 0. MASTER P MBER INSPECTED _ BY BILLED ACCOUNT NO. APPLICATION FOR 14ATER CUT -IR TO THE CITY OF ATLANTIC BEACH: Application is hereby made for 3/4" Sao water cut -in at the following address for one units. Cut -In charge of 85.00 plus 4.00 construction water Street No. 346 2nd Street Lot 17 Block 3 Subdivision AFB Ordered by: Roberts Ente.rprises, Inc. OVINER: Virgina Ford Mailing Address: 10166 Golf Club Dri r Jacksonville, Florida DATE-. ACCOUNT -NO. 7 V MEmER 110. DATE INSTALL7D : ED: THIS IS A DUPLEX. EACH UNIT WILL HAVE AN INDIVIDUAL METER, BUT ONLY ONE TAP FOR CONSTRUCTION WATER WILL BE NECESSARY. APPLICATION FOR WATER CUT -IN TO THE CITY OF ATLANTIC BEACH Application is hereby made for 3/4" tap water cut -in at the following address for one units. Cut -In charge of 85.00 OX ONX Street No. 346 2nd Street Lot 17 Block 3 Subdivision A/B Ordered by: Robe Enterprises, I nc. OWNER e Vi xgina Ford Mailing Address-. 10166 Golf Club Dri ve Jacksonville, Florida ;SATE ACCOUN "10. J ZL� 1ETER iTO. DATE IITSTALL'?D L APPLICATION FOR IiATER CUT -IF TO THE CITY OF ATLANTIC gFACH: Application is hereby made for 3/4" tap water cut -in at the following address for one units. Cut -In charge of 85.00 plus 4.00 construction water Street 0o. 346 2nd Street Lot 17 Flock 3 Subdivision AFB Ordered by: Roberts Enterprises, Inc. OUR I E R Virqina Ford P7ail.ing Address :. 10166 Golf Club Dri ve r a Jacksonville, Florida DATE ACCOU IT - 0. _2 I!ETER 110. DATC INS'TA.LL70 7 E THIS IS A DUPLEX. EACH UNIT WILL HAVE AN INDIVIDUAL METER, BUT ONLY ONE TAP FOR CONSTRUCTION WATER WILL BE NECESSARY. �-�� // CITY OF 4&i w 4c /S eacA - 9 914 ZLQ4 Office of Building Official R EST FOR INSPECTION Date vv& Time A.M. Permit No. Received PM Job Address Locality Owner's L Name Contractor BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL Framing ❑ Footing ❑ Rough Wiring ❑ Rough ❑ Air Cond. & ❑_ Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out ❑ Heating Insulation ❑ Lintel ❑ Final ❑ Sewer ❑ Fire Place ❑ READY FOR INSPECTION Pre Fab Mon. Tues. W A.M. Thurs. Friday Inspection Made A.M. P.M. Inspector al Inspectio Certificate of Occupancy ❑ Date PSR-3844 16662 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH P RMTT INFORMATION ------ ------ LOCATION INFORMATION rmit umber. 16662 k6dress: 346 SECOND STREET Permi Type:PLUMBING ATLANTIC BEACH. FLORIDA 3223-' ass o Work:ALTERATION LEGAL DESCRIPTION ----------- onstr. Type:Wf-)OD FRAME Block: Lot Twp 0 m Use:SINGLE FAMILY Section: 0 Subd: Rna* Dwellings: 0 gubdivision: Est. Value: 0.00 1mvrov. Cost: 0.00 Total Fees: 25.00 i d 25.00 6/16/1998 NEW HOSE BIBB LINE n IINIER INFORMATION -W APPLICATION FEES -. Vj M. FO RD ERMIT 25.00 1dr: 7 '11� SECOND STREET ATLANTIC BERCH. FLORIDA 3"' 'hone (904)249-2690 ONTRACTOR INFORMATION J V AND SON PLUMBING -Idr: 755 C•EARVIEW LANE ,NTLANTIC BEQACH, FLA. 32233 , dc: 0037856 Exp*, pe: 4 NOTES: NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS. ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. ATLANT - BEACH BUILDING DEPARTMENT By: CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION: OWNER OF PROPERTY: TELEPHONE NO. &/ �o PLUMBING CONTRACTOR CONTRACTOR'S ADDRESS STATE LICENSE NUMBER f a�> / g�� TELEPHONE HOW MANY OF THE FOLLOWING FIXTURES INSTALLED SINKS SHOWERS LAVATORY WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINE FLOOR DRAINS SHOWER PANS SEWER WATER REPIPE C' OTHER TOTAL FIXTURES: x $3.50 + $15.00 MINIMUM PERMIT FEE - $25.00 SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR: ----------------------------------------------------------------- INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247 -5826 SEWER CONNECTIONS MUST BE CALLED INTO PUBLIC WORKS FOR INSPECTION PRIOR TO COVERING UP - (904) 247 -5834 CITY OF Office Of Building Official REQUEST FOR INSPECTION Date — ` Y Time Permit No. �/ 7 Received — Job Address - - - -- Owner's Locality Name 0 l - - -- — — — - Contractor BUILDING CONCRETE ELECTRICAL Framing E7j Footing ❑ Rou BIND MECHANICAL Re Roofing ❑ Slab gh Wiring ❑ Rough n Air & Insulation _. Lintel ❑ Final p Pote ❑ Top Out ❑ Heating S ewer C Fire Place F, READY FOR INSPECTION S-'"4 Pre Fab v Wed. Thurs. Friday Inspection Made A.M. Inspector —P.M. _ Final Inspection Cl Certificate of Occupancy Date — -- -- -- - - -- Psf3l: 44 14201, DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH rt PERMIT INFORMATION ------- ------ LOCATION INFORMATION - - - -- Permit Number: 14207 Address: 346 SECOND STREET Pe I 4,m,t, T v' r�`�� PLUMBING ATLANTIC BEACH, FLORIDA 3- r ,- 1as 0 i W ar k:ALTERATION ------ -- LEGAL DESCRIPTION ----------- o tr o os6d e : M8L ILY Re 4 ubd: n F n Tgp ERO�h o Lot M r - wellings: 0 Subdivision! E t. Value! 0.00 implov. Cost: 0.4r Total, Fees. 25.00 Amtunt Paid: 25.00 �L SINK & DISHWASHER OWNER, ' INFORMATION APPLICATION FEES Nam— PERMIT 25.40 Addr; 346,A5ECC)ND STREET T C BEACH,, FLORIDA IP 1- C6lfTRRCTCR INFORMATION Name: A.D.T. SERVI INC tl , id r , 2 ERNRST STREET JACKSONVItLE, FL 32205 .,ic; CFCQ35761 Exp Eype' 4 NOTES: NOTICE — ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS." ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. $E5.00 14 Datp: 6/30/97 91 Receipt: 0067075 CASH ATLANTIC BEACH BUILD G D ARTMENT 00100003221000 By: L � CITY OF ATLANTIC BEACH APPLICCATION FOR PLUMBING PERMIT JOB LOCATION: 3 �O G r OWNER OF PROPERTY: V m PLUMBING CONTRACTOR: CONTRACTOR'S ADDRESS: STATE LICENSE NUMBER: �F �3J 7�� TELEPHONE: - �� HOW MANY OF THE FOLLOWING FIXTURES INSTALLED SINKS SHOWERS LAVATORIES WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINES FLOOR DRAINS SHOWER PANS OTHER TOTAL FIXTURES: _ X 3.50 + $15.00 Z Z` O MINIMUM PERMIT FEE = $25.00 SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR: z ------------- INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE 1994 STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247 -5826 SEWER CONNECTIONS MUST BE CALLED IN TO PUBLIC WORKS FOR INSPECTION PRIOR TO COVERING UP - (904) 247 -5834.